van Montfoort Douwe O, van Kampen Paulien M, Huijsmans Pol E
Haga ziekenhuis, The Hague, The Netherlands.
Haga ziekenhuis, The Hague, The Netherlands.
Arthroscopy. 2016 Mar;32(3):436-44. doi: 10.1016/j.arthro.2015.08.027.
To determine the influence of epinephrine saline irrigation in therapeutic shoulder arthroscopy procedures on the clarity of arthroscopic view. Three subgroups were analyzed; (1) Bankart/SLAP repairs; (2) rotator cuff repairs; and (3) subacromial procedures without rotator cuff repair. Secondary objectives were to evaluate the influence on total operating time and potential cardiovascular adverse reactions.
The design of the study was a prospective, randomized, double-blind controlled trial. A total of 101 patients were included. Pressure pump-controlled regular saline irrigation fluid was used in the control group. In the epinephrine group, epinephrine (0.33 mg/L) was added to the saline-irrigation fluid. Visual clarity was rated by a Numeric Rating Scale. Total operation time, total use of irrigation fluid, increases in pump pressure, heart rate, blood pressure, and electrocautery use were registered.
Visual clarity (P = .002) was significantly better and total operating time (P = .008) significantly shorter in the epinephrine group. Total irrigation fluid used was significantly lower in the epinephrine group (P = .001). The greatest effect on visual clarity and shortening of operation time up to 15 minutes was seen in Bankart and SLAP repairs. No significant effect of the addition of epinephrine on heart rate and blood pressure was observed.
The addition of epinephrine (0.33 mg/L) to irrigation fluid significantly improves visual clarity in most common types of therapeutic shoulder arthroscopy. A significant reduction in total operating time and use of irrigation fluid was observed. The greatest effect on visual clarity and shortening of operation time was seen in Bankart and SLAP group. Therefore, one of our initial hypotheses that the greatest effect would be observed in subacromial and rotator cuff repair procedures was not supported by the data presented. No cardiovascular adverse reactions were seen.
Level 1, Randomized controlled trial.
确定肾上腺素盐水冲洗在治疗性肩关节镜手术中对关节镜视野清晰度的影响。分析了三个亚组：（1）Bankart/SLAP修复术；（2）肩袖修复术；（3）无肩袖修复的肩峰下手术。次要目标是评估对总手术时间和潜在心血管不良反应的影响。
本研究设计为前瞻性、随机、双盲对照试验。共纳入101例患者。对照组使用压力泵控制的常规盐水冲洗液。肾上腺素组在盐水冲洗液中加入肾上腺素（0.33mg/L）。视觉清晰度采用数字评分量表进行评分。记录总手术时间、冲洗液总用量、泵压升高、心率、血压和电灼使用情况。
肾上腺素组的视觉清晰度（P = 0.002）明显更好，总手术时间（P = 0.008）明显更短。肾上腺素组的冲洗液总用量明显更低（P = 0.001）。在Bankart和SLAP修复术中，对视觉清晰度和手术时间缩短达15分钟的影响最大。未观察到添加肾上腺素对心率和血压有显著影响。
在冲洗液中添加肾上腺素（0.33mg/L）可显著提高大多数常见类型治疗性肩关节镜手术的视觉清晰度。观察到总手术时间和冲洗液用量显著减少。在Bankart和SLAP组中，对视觉清晰度和手术时间缩短的影响最大。因此，我们最初的假设之一，即在肩峰下和肩袖修复手术中观察到的影响最大，未得到所呈现数据的支持。未观察到心血管不良反应。
1级，随机对照试验。
